L’incapacité au travail liée aux troubles musculosquelettiques : aspects théoriques et différences de genre

Introduction : Cette thèse est constituée de trois articles liés les uns aux autres. Le premier s’attache à clarifier les perspectives théoriques et problèmes conceptuels entourant la notion de capacité/incapacité au travail, sa définition et son évolution au fil du temps. Les deuxième et troisième articles visent à évaluer les effets différentiels selon le genre de déterminants du retour au travail (RAT) et de la durée d’indemnisation ainsi que les coûts associés, dans une population de travailleurs indemnisés à long terme pour troubles musculosquelettiques (TMS). Méthodes : Dans le premier article, une revue systématique des définitions de l’(in)capacité au travail et une analyse comparative basée sur la théorisation ancrée débouchent sur une carte conceptuelle intégrative. Dans le second article, une cohorte de 455 adultes en incapacité à long terme pour TMS au dos/cou/membres supérieurs est suivie cinq ans au travers d’entretiens structurés et de données d’indemnisation. Des modèles de Cox stratifiés par genre ont été utilisés pour évaluer la durée jusqu’au premier RAT. Dans le troisième article, une cohorte populationnelle de 13,073 hommes et 9032 femmes en incapacité prolongée pour TMS au dos/cou/membres supérieurs a été suivie pendant trois ans à l’aide de données administratives. Des modèles de Cox stratifiés par genre ont été utilisés pour étudier la durée d’indemnisation et détecter les effets dépendants du temps. Les coûts ont également été examinés. Résultats : Les définitions analysées dans la première étude ne reflètent pas une vision intégrée et partagée de l’(in)capacité au travail. Cependant, un consensus relatif semble émerger qu’il s’agit d’un concept relationnel, résultant de l’interaction de multiples dimensions aux niveaux individuel, organisationnel et sociétal. La seconde étude montre que malgré des courbes de survie jusqu’au RAT similaires entre hommes et femmes (p =0.920), plusieurs déterminants diffèrent selon le genre. Les femmes plus âgées (HR=0.734, par tranches de 10 ans), d’un statut économique perçu comme pauvre (HR=0.625), travaillant ≥40 heures/semaine en ayant des personnes à charge (HR=0.508) et ne connaissant pas l’existence d’un programme de santé et sécurité sur leur lieu de travail (HR=0.598) retournent moins vite au travail, tandis qu’un revenu brut annuel plus élevé (par $10,000) est un facteur facilitant (HR=1.225). Les hommes de plus de 55 ans (HR=0.458), au statut économique perçu comme pauvre (HR=0.653), travaillant ≥40 heures/semaine avec une charge de travail physique perçue élevée (HR=0.720) et une plus grande précarité d’emploi (HR=0.825) retournent moins rapidement au travail. La troisième étude a révélé que trois ans après la lésion, 12.3% des hommes et 7.3% des femmes étaient encore indemnisés, avec un ratio de coûts homme-femme pour l’ensemble des réclamations de 2.1 :1. L’effet de certain prédicteurs (e.g. revenu, siège de lésion, industrie) varie selon le genre. De plus, l’effet de l’âge chez les hommes et l’effet de l’historique d’indemnisation chez les femmes varient dans le temps. Conclusion : La façon de définir l’(in)capacité au travail a des implications importantes pour la recherche, l’indemnisation et la réadaptation. Les résultats confirment également la pertinence d’investiguer les déterminants du RAT et de l’indemnisation selon le genre.

A study of sexuality following traumatic brain injury : moving towards the validation of a biopsychosocial model

L’étude de la sexualité dans le contexte des maladies neurologiques est un domaine émergent qui nous permet de mieux comprendre les corrélats cérébraux et neurocomportementaux de divers aspects de la sexualité. Les changements au sujet de la sexualité sont fréquents à la suite de troubles neurologiques tels que les blessures de la moelle épinière, la sclérose en plaques, l’accident vasculaire cérébral, l'épilepsie et les traumatismes craniocérébraux (TCC). Compte tenu de la complexité de la sexualité après un TCC, celle-ci doit être analysée à partir d'une perspective biopsychosociale qui comprend trois facteurs interdépendants : a) les facteurs neuropsychologiques et psychologiques, b) les variables médicales et physiques, et c) les facteurs relationnels. L’objectif de cette thèse était d’étudier certains éléments de la sexualité auprès de personnes ayant subi un TCC afin de fournir des preuves empiriques pour contribuer à la validation d’une perspective biopsychosociale de la sexualité après un TCC. Trois études quantitatives originales ont été effectuées auprès de personnes ayant subi un TCC léger, modéré ou grave et ayant reçu des services de réadaptation post-TCC, et d’un groupe de témoins en bonne santé, tous vivant dans la communauté. Les groupes étaient comparables en ce qui concerne l’âge, le sexe, le nombre d’années de scolarité, le statut d’emploi et relationnel, et le revenu annuel. Les variables ciblant la sexualité, incluses dans cette thèse, étaient la qualité de vie sexuelle, le comportement sexuel à risque, et la sociosexualité (p. ex., les différences individuelles en ce qui concerne la volonté d’une personne à avoir des relations sexuelles sans engagement). Les variables neuropsychologiques et psychologiques incluaient les fonctions exécutives, la dépression et l’anxiété. Les aspects médicaux et physiques englobaient les symptômes postcommotionnels. Les facteurs relationnels comprenaient les attitudes envers l'infidélité. Les résultats démontrent que par rapport aux témoins en santé, les individus avec un TCC ont montré une diminution de la qualité de vie sexuelle, alors que les groupes étaient comparables sur le plan du comportement sexuel à risque, de la sociosexualité et des attitudes envers l'infidélité. Par ailleurs, les résultats ont montré une différence entre les hommes et les femmes sur le plan de la sociosexualité (p. ex., plus restrictive chez la femme). Chez les personnes ayant subi un TCC, une faible qualité de vie sexuelle était significativement associée à un nombre élevé de symptômes postcommotionnels, un comportement sexuel plus à risque corrélait avec une plus grande fréquence de symptômes dysexécutifs, et une plus faible acceptation de l'infidélité était liée à une sociosexualité moins restrictive. Les résultats de ces trois études soutiennent une perspective biopsychosociale de la sexualité après le TCC. Elles apportent des connaissances nouvelles en ce qui a trait aux domaines de la sexualité qui peuvent être touchés après un TCC, ainsi qu’à certaines variables neuropsychologiques et psychologiques, médicales et physiques, et relationnelles qui sont associées à ces changements. Les implications théoriques, ainsi que pour la pratique clinique et la réadaptation sont discutées. Les limitations des études sont présentées et des recommandations pour la recherche sont proposées. Le modèle biopsychosocial peut être utilisé comme une référence pour guider la recherche future dans ce domaine. D’autres études sur la sexualité et le développement d'interventions multidisciplinaires dans ce domaine pour les personnes TCC sont nécessaires.

Community Participation in Ecotourism: An Inclusive Development Option for Kerala

The inferences obtained from the study are presented in coherent area-specific levels so as to understand the ecotourism and its sub-sector areas for the researchers and policy makers about the issues, importances and potentialities of the sector. An analysis of the tourism sector in Kerala has shown tremendous growth both in terms of tourist arrivals and in terms of revenue generation from direct and indirect sources. The foreign tourist visitors in Kerala in 2014 was 9,23,336 which shows 7.60 percent increase from the last year and the domestic tourist visitors were 1,16,95,411 which again shows 7.71 percent increase, is a clear evidence of its potential. In 2014 the industry contributed revenue of 24885.44 crores from direct and indirect sources giving rise to an increase of 12.11 percent from the last year. A dichotomy of tourists and ecotourists shows that tourists in the ecotourism destinations come to 42.6 percent of the total, shows the scope, significance and its potential. Correlation of zone-wise tourist arrivals based on the ecotourism destinations highlights the fact that with only 19 of the 64 destinations that come in the central zone are the most preferred centres (around 54 percent) for the domestic as well as foreign tourists. The north zone encompassing 6 districts with rich biodiversity shows that the tourists‟ arrival patterns exhibit less promising results. Though the north zone has 31 ecotourism destinations of the state receives only 6.19 percent of the foreign visitors. The ecotourism activities in the state are primarily managed by the Eco-Development Committees (EDCs) and the Vana Samrakshana Samithies (VSS) under the Forest Development Agency of Kerala. Social class-wise categorization of membership shows that 13142 families have membership in 190 EDCs with SC (28 percent), ST (33 percent) and other marginalised communities (39 percent). But this in the VSS shows that 400 VSS have 59085 members actively engaged in ecotourism activities and social category of the VSS makes clear that majority are from the other marginalized fringe households with 62 percent where as the participation of SC is 12 percent and ST is 26 percent. An evaluation of the socio-economic and demographic matrix of the community members involved in ecotourism activities brings out region specific differences. About 75.70 percent of the respondents are males and the rest are females. Majority of the respondents (about 60 percent) are in the age group of 20 to 40 years, followed by the age group of 40-50 (20 percent). The average age of respondents in the three zones is between 35 and 37 years. The majority of the respondents are married, a few are unmarried. Average family size is 4-5 members and differences are identified among zones. Average number of adults per household is 3 and child per household is 2. Majority have an education of 10th class and below i.e. about 60 percent of the sample have only basic school education like primary, secondary and high school (i.e. up to SSLC but not passed) level. About 18 percent are SSLC passed, 10 percent are undergraduates whereas 6 percent constitute respondents having qualification of graduation and above. Majority of the „graduates and above‟ are from south and central zone. Inter-zone differences in educational profile are also identified with lesser number of „graduates and above‟ are identified in the north zone compared to the other two zones. Investigating into the income and livelihood options of the respondents gives insight about the prominence of ecotourism as an employment and livelihood option for the community members, as more than 90 percent of the respondents have cited tourism sector as their main employment option. Most (49.30 percent) of respondents get 100 percent income from tourism related activities, followed by 37.30 percent of community members have income between 75-99 percent from tourism whereas the rest (13 percent) have less than 74 percent of their income from tourism and there exists difference between zones and percentage of income. Financial habit shows that about 49.7 percent hold active bank accounts, 61 percent have savings behaviour and 73.8 percent have indebtedness. Analysis about the ownership of house brings to light that 37 percent of respondents live in their own house followed by 25.7 percent in government funded/provided house and 21 percent in their parent‟s house and 3.5 percent in rented house. About 12 percent of the respondents have other kinds of accommodation facilities such as staff quarters, etc. But in the case of north zone majority i.e. 52 percent primarily depend on the government funded house indicating the effectiveness of government housing programme. Standard of living measured in SLI frameworks shows that majority of the respondents have medium SLI values (42.3 percent); the remaining 47.7 percent have low SLI and 10 percent have high SLI. The community members have been benefitted immensely from forest and its resources. Since the ecotourism destinations are located amidst the wildlife settings, majority of them depend on forest for their livelihood. The information on the tourist‟s demographic characteristics like age, sex, educational qualification and annual income show that the age category of domestic and foreign tourists falls below the age group of less than 35 years (about 65 percent), whereas only 16 percent of tourists are aged above 46 years. The age group below 25 years consists of more international tourists (31.3 percent) compared to the proportion of domestic tourists (12.5 percent). Male-female ratio shows that the males constitute 56 percent of the sample and females with 44 percent. The factors determining the impact of ecotourism programmes in the community was evaluated with the aid of a factor analysis with 12 selected statements. The worries and concerns of the community members about the impact of ecotourism on the environment are well understood from this analysis. It can be drawn that environment protection and the role of ecotourism in improving the income and livelihood options of the local communities is the most important factor concerning the community members.

Agricultural practices and horizontal nutrient balances in urban gardens and the alternative use of urban agricultural land in Khartoum, Sudan

The surge in the urban population evident in most developing countries is a worldwide phenomenon, and often the result of drought, conflicts, poverty and the lack of education opportunities. In parallel with the growth of the cities is the growing need for food which leads to the burgeoning expansion of urban and peri-urban agriculture (UPA). In this context, urban agriculture (UA) contributes significantly to supplying local markets with both vegetable and animal produce. As an income generating activity, UA also contributes to the livelihoods of poor urban dwellers. In order to evaluate the nutrient status of urban soils in relation to garden management, this study assessed nutrient fluxes (inputs and outputs) in gardens on urban Gerif soils on the banks of the River Nile in Khartoum, the capital city of Sudan. To achieve this objective, a preliminary baseline survey was carried out to describe the structure of the existing garden systems. In cooperation with the author of another PhD thesis (Ms. Ishtiag Abdalla), alternative uses of cow dung in brick making kilns in urban Khartoum were assessed; and the socio-economic criteria of the brick kiln owners or agents, economical and plant nutritional value of animal dung and the gaseous emission related to brick making activities were assessed. A total of 40 household heads were interviewed using a semi-structured questionnaire to collect information on demographic, socio-economic and migratory characteristics of the household members, the gardening systems used and the problems encountered in urban gardening. Based on the results of this survey, gardens were divided into three groups: mixed vegetable-fodder gardens, mixed vegetable-subsistence livestock gardens and pure vegetable gardens. The results revealed that UA is the exclusive domain of men, 80% of them non-native to Khartoum. The harvested produce in all gardens was market oriented and represented the main source of income for 83% of the gardeners. Fast growing leafy vegetables such as Jew’s mallow (Corchorous olitorius L.), purslane (Portulaca oleracea L.) and rocket (Eruca sativa Mill.) were the dominant cultivated species. Most of the gardens (95%) were continuously cultivated throughout the year without any fallow period, unless they were flooded. Gardeners were not generally aware of the importance of crop diversity, which may help them overcome the strongly fluctuating market prices for their produce and thereby strengthen the contributions of UA to the overall productivity of the city. To measure nutrient fluxes, four gardens were selected and their nutrients inputs and outputs flows were monitored. In each garden, all plots were monitored for quantification of nutrient inputs and outputs. To determine soil chemical fertility parameters in each of the studied gardens, soil samples were taken from three selected plots at the beginning of the study in October 2007 (gardens L1, L2 and H1) and in April 2008 (garden H2) and at the end of the study period in March 2010. Additional soil sampling occurred in May 2009 to assess changes in the soil nutrient status after the River Nile flood of 2008 had receded. Samples of rain and irrigation water (river and well-water) were analyzed for nitrogen (N), phosphorus (P), potassium (K) and carbon (C) content to determine their nutrient inputs. Catchment traps were installed to quantify the sediment yield from the River Nile flood. To quantify the nutrient inputs of sediments, samples were analyzed for N, P, K and organic carbon (Corg) content, cation exchange capacity (CEC) and the particle size distribution. The total nutrient inputs were calculated by multiplying the sediment nutrient content by total sediment deposits on individual gardens. Nutrient output in the form of harvested yield was quantified at harvest of each crop. Plant samples from each field were dried, and analyzed for their N, P, K and Corg content. Cumulative leaching losses of mineral N and P were estimated in a single plot in garden L1 from December 1st 2008 to July 1st 2009 using 12 ion exchange resins cartridges. Nutrients were extracted and analyzed for nitrate (NO3--N), ammonium (NH4+-N) and phosphate PO4-3-P. Changes in soil nutrient balance were assessed as inputs minus outputs. The results showed that across gardens, soil N and P concentrations increased from 2007 to 2009, while particle size distribution remained unchanged. Sediment loads and their respective contents of N, P and Corg decreased significantly (P < 0.05) from the gardens of the downstream lowlands (L1 and L2) to the gardens of the upstream highlands (H1 and H2). No significant difference was found in K deposits. None of the gardens received organic fertilizers and the only mineral fertilizer applied was urea (46-0-0). This equaled 29, 30, 54, and 67% of total N inputs to gardens L1, L2, H1, and H2, respectively. Sediment deposits of the River Nile floods contributed on average 67, 94, 6 and 42% to the total N, P, K and C inputs in lowland gardens and 33, 86, 4 and 37% of total N, P, K and C inputs in highland gardens. Irrigation water and rainfall contributed substantially to K inputs representing 96, 92, 94 and 96% of total K influxes in garden L1, L2, H1 and H2, respectively. Following the same order, total annual DM yields in the gardens were 26, 18, 16 and 1.8 t ha-1. Annual leaching losses were estimated to be 0.02 kg NH4+-N ha-1 (SE = 0.004), 0.03 kg NO3--N ha-1 (SE = 0.002) and 0.005 kg PO4-3-P ha-1 (SE = 0.0007). Differences between nutrient inputs and outputs indicated negative nutrient balances for P and K and positive balances of N and C for all gardens. The negative balances in P and K call for adoptions of new agricultural techniques such as regular manure additions or mulching which may enhance the soil organic matter status. A quantification of fluxes not measured in our study such as N2-fixation, dry deposition and gaseous emissions of C and N would be necessary to comprehensively assess the sustainability of these intensive gardening systems. The second part of the survey dealt with the brick making kilns. A total of 50 brick kiln owners/or agents were interviewed from July to August 2009, using a semi-structured questionnaire. The data collected included general information such as age, family size, education, land ownership, number of kilns managed and/or owned, number of months that kilns were in operation, quantity of inputs (cow dung and fuel wood) used, prices of inputs and products across the production season. Information related to the share value of the land on which the kilns were built and annual income for urban farmers and annual returns from dung for the animal raisers was also collected. Using descriptive statistics, budget calculation and Gini coefficient, the results indicated that renting the land to brick making kilns yields a 5-fold higher return than the rent for agriculture. Gini coefficient showed that the kiln owners had a more equal income distribution compared to farmers. To estimate emission of greenhouse gases (GHGs) and losses of N, P, K, Corg and DM from cow dung when used in brick making, samples of cow dung (loose and compacted) were collected from different kilns and analyzed for their N, P, K and Corg content. The procedure modified by the Intergovernmental Panel on Climate Change (IPCC, 1994) was used to estimate the gaseous emissions of cow dung and fuel wood. The amount of deforested wood was estimated according to the default values for wood density given by Dixon et al. (1991) and the expansion ratio for branches and small trees given by Brown et al. (1989). The data showed the monetary value of added N and P from cow dung was lower than for mineral fertilizers. Annual consumption of compacted dung (381 t DM) as biomass fuel by far exceeded the consumption of fuel wood (36 t DM). Gaseous emissions from cow dung and fuel wood were dominated by CO2, CO and CH4. Considering that Gerif land in urban Khartoum supports a multifunctional land use system, efficient use of natural resources (forest, dung, land and water) will enhance the sustainability of the UA and brick making activities. Adoption of new kilns with higher energy efficiency will reduce the amount of biomass fuels (cow dung and wood) used the amount of GHGs emitted and the threat to the few remaining forests.

The bond scheme

Under the bond scheme, a pre-determined series of payments would compensate farmers for lost revenues resulting from policy change. Unlike the Single Payment Scheme, payments would be fully decoupled: recipients would not have to retain farmland, or remain in agriculture. If vested in a paper asset, the guaranteed, unencumbered, income stream would be similar to that from a government bond. Recipients could exchange this for a capital sum reflecting the net present value of future payments, and reinvest in other business ventures, either on- or offfarm.With a finite, declining flow of payments, budget expenditure would reduce, releasing funds for other uses.

Affordable Housing in Kennebec County

The U.S. Department of Housing and Urban Development defines affordable housing as a household paying no more than 30 percent of its annual income on housing. That is, families who pay more than 30 percent of their income on housing are considered cost burdened and may have difficulty affording necessities such as food, clothing, healthcare, and transportation. This project focused on Kennebec County, Maine. Between 1990 and 2000, market demand for housing increased at a faster rate than did the supply of housing. Despite the addition of 6,719 homes, the average home price increased faster than average household income. This raises the question of just how many households in Kennebec County are facing unaffordable housing. Using shapefiles and data provided by the US Census Bureau, a map was created with ArcGIS to illustrate the percentage of households, down to the Census Block level of detail, that are paying more than 30 percent of their income to housing. By looking at this information I was able to get a better picture of the housing situation and where in the county households are having the hardest time meeting their needs. The results indicate that households in the more urbanized sections of the county are more likely than rurally located households to be facing unaffordable housing. Namely, Waterville and Augusta held the highest percentage of households paying more than 30 percent of their income for housing.

Renda mínima garantida - prós e contras

O projeto procura levantar aspectos positivos e negativos de um programa de renda mínima. Examina também experiências de programas de dispêndio para os pobres em países desenvolvidos e comenta sobre aspectos que poderiam ser melhor avaliados por pesquisadores brasileiros.

Financial guarantees in Brazilian life insurance and pension plans

Recently regulated Brazilian life and pension products offer a benefit structure composed of minimum guaranteed annual rate, in°ation adjustment according to a price index and participation on an investment fund performance. We present a valuation model for these products. We establish a fair condition relationship between minimum guarantees and participation rates, and explore its behavior over a space of maturities, interest rates, and also fund and price index volatilities and correlation. Besides consistency to reference models, we found that the effect of the fund volatility is conditioned to the price index volatility level and the correlation between them.

Distribuição espacial da população de sessenta anos e mais no município de Botucatu-SP

Pós-graduação em Saúde Coletiva - FMB

Perfil da renda e do volume dos resíduos sólidos urbanos da associação de catadores de São Manuel - SP

The implementation of residue selective collection has brought to the city of Sao Manuel an incalculable benefit. It brought a better life for a group of adults and children that lives in a humanitarian condition of extreme poverty. These people live in an open-air dump, disputing the remains found in fifteen tons of garbage that are deposited at the site almost every day.The objective of this paper is to present thecollectors annual income profile and the volume of solid waste collected.To present these factors, the total and fractionated amount according to their material items, collected since the creation of the Association in February 2003 until December 2008, were considered., In addition,the social gains were enumerated. These factors were developed from a theoretical base for municipal solid waste involving environmental, social, and financial concepts. Based on these results it was found that the ACAPEL income value was above the average of other income indicators of the population analyzed, besides the social value enhance that the creation of the Association brought to the people who work there.

THE ROLE OF PEST CONTROL OPERATORS IN VERTEBRATE PEST CONTROL

The National Pest Control Association, which I represent, accepts for membership those persons or firms which are actively engaged in the performance of structural pest control services for hire to the public at large and which are in sympathy with the purposes of the Association. The pest control operator in this context might be called a commercial pest control operator to distinguish him from those doing similar work but who are employed by governmental agencies or within large commercial organizations. Pest control is a growing industry with a gross annual income of 300-350 million dollars. It is estimated to contain more than 5,000 firms employing about 25,000 productive workers. Many of these servicemen, possibly 15,000, are doing vertebrate pest control every day as they combat commensal rodents. A much smaller number, usually specialists or persons normally doing super¬visory work, are also engaged in the control of pest birds and a variety of miscellaneous vertebrates. With approximately 15,000 servicemen making at least 10 contacts a day with the public, it is readily apparent that whatever opportunity the general public has to judge the success or failure of vertebrate pest control practice is largely influenced by the work of the pest control industry.

Cognitive function in patients with chronic pain treated with opioids: characteristics and associated factors

Background The paucity of studies regarding cognitive function in patients with chronic pain, and growing evidence regarding the cognitive effects of pain and opioids on cognitive function prompted us to assess cognition via neuropsychological measurement in patients with chronic non-cancer pain treated with opioids. Methods In this cross-sectional study, 49 patients were assessed by Continuous Reaction Time, Finger Tapping, Digit Span, Trail Making Test-B and Mini-mental State Examination tests. Linear regressions were applied. Results Patients scored poorly in the Trail Making Test-B (mean?=?107.6?s, SD?=?61.0, cut-off?=?91?s); and adequately on all other tests. Several associations among independent variables and cognitive tests were observed. In the multiple regression analyses, the variables associated with statistically significant poor cognitive performance were female sex, higher age, lower annual income, lower schooling, anxiety, depression, tiredness, lower opioid dose, and more than 5?h of sleep the night before assessment (P?<?0.05). Conclusions Patients with chronic pain may have cognitive dysfunction related to some reversible factors, which can be optimized by therapeutic interventions.

Alveolar echinococcosis: from a deadly disease to a well-controlled infection. Relative survival and economic analysis in Switzerland over the last 35 years

BACKGROUND/AIMS: Alveolar echinococcosis (AE) is a serious liver disease. The aim of this study was to explore the long-term prognosis of AE patients, the burden of this disease in Switzerland and the cost-effectiveness of treatment. METHODS: Relative survival analysis was undertaken using a national database with 329 patient records. 155 representative cases had sufficient details regarding treatment costs and patient outcome to estimate the financial implications and treatment costs of AE. RESULTS: For an average 54-year-old patient diagnosed with AE in 1970 the life expectancy was estimated to be reduced by 18.2 and 21.3 years for men and women, respectively. By 2005 this was reduced to approximately 3.5 and 2.6 years, respectively. Patients undergoing radical surgery had a better outcome, whereas the older patients had a poorer prognosis than the younger patients. Costs amount to approximately Euro108,762 per patient. Assuming the improved life expectancy of AE patients is due to modern treatment the cost per disability-adjusted life years (DALY) saved is approximately Euro6,032. CONCLUSIONS: Current treatments have substantially improved the prognosis of AE patients compared to the 1970s. The cost per DALY saved is low compared to the average national annual income. Hence, AE treatment is highly cost-effective in Switzerland.

UM ESTUDO SOBRE A IMPORTÂNCIA DO USO DAS FERRAMENTAS DE CONTROLE GERENCIAL NAS MICRO, PEQUENAS E MÉDIAS EMPRESAS INDUSTRIAIS NO MUNICÍPIO DE SÃO CAETANO DO SUL

O objetivo desse estudo foi evidenciar o uso das ferramentas de controle gerencial que auxiliam no processo de tomada de decisão nas Micros, Pequenas e Médias Empresas, no município de SCSul. Entende-se, que na atualidade esses instrumentos devem ser alinhados com a realidade dessas organizações e as informações extraídas por estas devem ser a base para a tomada de decisão que perpetuem a riqueza dos investidores. O procedimento metodológico aplicado na escolha das empresas pesquisadas foi o critério de conveniência, utilizando o método de raciocínio dedutivo, através de aplicação de um questionário em 296 empresas, pelo a qual 18,6% destas se depuseram a responder o questionário. As empresas foram classificadas de acordo com o faturamento bruto anual estabelecido pela Receita Federal. Após a análise dos resultados, foi possível detectar que cerca de 41% dessas organizações estão a mais de 20 anos no mercado, o que demonstra uma boa consolidação no mercado. Detecta-se, também, que estes empresários-gerentes possuem uma forte formação superior: 31,27% pós-graduados e 22,22% graduados, o que pode ser um diferencial na gestão desses negócios. Como o pressuposto dessa pesquisa foi de analisar: se as MPME s industriais no município de SCSul estão utilizando as ferramentas de controle gerencial em seu processo de gestão para tomada de decisão, diante das análises efetuadas, tanto pelo o estudo de campo com bibliográfica, conclui-se que a tomada de decisão nessas empresas está baseada nas ferramentas de controle e que estas possuem um bom controle dos seus negócios contrariando o que se esperava.

UM ESTUDO SOBRE A IMPORTÂNCIA DO USO DAS FERRAMENTAS DE CONTROLE GERENCIAL NAS MICRO, PEQUENAS E MÉDIAS EMPRESAS INDUSTRIAIS NO MUNICÍPIO DE SÃO CAETANO DO SUL

O objetivo desse estudo foi evidenciar o uso das ferramentas de controle gerencial que auxiliam no processo de tomada de decisão nas Micros, Pequenas e Médias Empresas, no município de SCSul. Entende-se, que na atualidade esses instrumentos devem ser alinhados com a realidade dessas organizações e as informações extraídas por estas devem ser a base para a tomada de decisão que perpetuem a riqueza dos investidores. O procedimento metodológico aplicado na escolha das empresas pesquisadas foi o critério de conveniência, utilizando o método de raciocínio dedutivo, através de aplicação de um questionário em 296 empresas, pelo a qual 18,6% destas se depuseram a responder o questionário. As empresas foram classificadas de acordo com o faturamento bruto anual estabelecido pela Receita Federal. Após a análise dos resultados, foi possível detectar que cerca de 41% dessas organizações estão a mais de 20 anos no mercado, o que demonstra uma boa consolidação no mercado. Detecta-se, também, que estes empresários-gerentes possuem uma forte formação superior: 31,27% pós-graduados e 22,22% graduados, o que pode ser um diferencial na gestão desses negócios. Como o pressuposto dessa pesquisa foi de analisar: se as MPME s industriais no município de SCSul estão utilizando as ferramentas de controle gerencial em seu processo de gestão para tomada de decisão, diante das análises efetuadas, tanto pelo o estudo de campo com bibliográfica, conclui-se que a tomada de decisão nessas empresas está baseada nas ferramentas de controle e que estas possuem um bom controle dos seus negócios contrariando o que se esperava.